The answer to any question about the best depression treatment for young adults has changed significantly in recent decades. Before the 21st century, we labored under the misconception that disorders like depression and other mental health problems were a sign of weakness or frailty. Many people – professionals and laypeople alike – thought treatment for mental health disorders was only for patients who were incapable of managing the ups and downs of life, rather than for people with a legitimate medical condition.
Thankfully, two developments made those barriers to care a thing of the past.
First, the widespread acceptance of the medical model of mental health disorders changed our overall perspective. The medical model asserts that a mental health disorder is no different than a physical disorder, for two primary reasons:
- Anyone can develop a mental health disorder, the same as anyone can develop a physical illness.
- Mental health disorder responds well to evidence-based treatment, just like a physical disorder does.
Second, the development of the integrated model of treatment expanded our understanding of what health and healing mean. Integrated care means when we support a patient with an illness, we support the whole person, rather than addressing the symptoms of the disorder and nothing else. For example, an integrated approach to treating diabetes typically involves lifestyle changes and medication.
Physicians prescribe medication, but they also recommend changing daily habits in order to support total health.
Our new approach to treating mental health disorders is similar: a treatment plan for depression in 2024 typically involves therapy, lifestyle changes, and medication.
That’s a major change from just two to three decades ago, when most treatment involved psychotherapy and medication, and the things we hear so much about today – stress management, self-care, exercise, nutrition, social support – were rarely, if ever, included in depression treatment for young adults.
Prevalence of Depression Among Young Adults in 2023
The reason we need to understand what depression treatment works best for young adults is simple: millions of young adults in the U.S have clinical depression. We’ll share the latest figures on the prevalence of depression among young adults in the U.S., age 18-25, as reported by the 2023 National Survey on Drug Use and Health (2023 NSDUH). For context and perspective, we’ll include prevalence rates for all adult age groups. In these figures, major depressive episode (MDE) is a proxy metric for a diagnosis of major depressive disorder (MDD).
Here’s the data:
Major Depressive Episode (MDE) 2023
MDE 18+:
- MDE: 8.5%
- ~28.1 million people
- Severe MDE: 5.9%
- ~19.5 million people
18-25:
- MDE: 17.5%
- ~4 million people
- Severe MDE: 12.9%
- ~3 million people
26-49:
- MDE: 10.2%
- ~4 million
- Severe MDE: 7.4%
- ~2.9 million
50+:
- MDE: 4.5%
- ~5.1 million
- Severe MDE: 2.7%
- ~3.1 million
What we see here is that the prevalence rate of depression is far greater for young adults ag 18-25 than for any other age group. In fact, in raw numbers, this small group spanning seven years reports prevalence rates roughly equivalent to age groups at least twice as broad, such as the 26-49 group that includes a twenty-three-year spread, and the 50+ group that includes a 30+ year spread.
Next, we’ll share the latest data – also from the 2023 NSDUH – on rates of treatment among people who reported MDE or severe mental illness (SMI). Treatment data for adults with MDE with severe impairment is unavailable.
Here’s the data:
Received Treatment for Major Depressive Episode (MDE) or Serious Mental Illness (SMI) 2023
18+:
- MDE: 67%
- SMI: 71.1%
18-25:
- MDE: 58.8%
- SMI: 65%
26-49:
- MDE: 70%
- SMI: 75.2%
50+:
- MDE: 69%
- SMI: 66.9%
What we see here is something we need to change. The age group with the highest prevalence of depressive disorders and serious mental illness received treatment at the lowest rates of all age groups.
That’s a phenomenon we can change, because there are several effective treatments available for young adults.
Depression Treatment for Young Adults: Integrated, Holistic, Evidence-Based
Research shows that the most effective depression treatment for young adults may come in many forms, but the types of programs that consistently yield the best results follow the integrated treatment model.
Integrated treatment, initially developed for co-occurring mental health and substance use disorders, is now recognized as an effective approach to most mental and behavioral disorders.
Integrated means an approach similar to what most people think of as holistic: it refers to an intentional and appropriate mix of individual psychotherapy/counseling, group psychotherapy/counseling, family psychotherapy/counseling, medication (when indicated), lifestyle changes. Additional modes of support including mindfulness, expressive therapies, experiential therapies, and peer-based community support.
The goal of the integrated model is to treat the whole person, and address any challenges they face in order to help them reach a state of total wellness, rather than simply treat them until they report the absence of symptoms of a particular mental or behavioral disorder.
Depression Treatment for Young Adults: Components of Care
Individual therapies may include:
- Cognitive behavioral therapy (CBT)
- Acceptance and Commitment Therapy (ACT)
- Motivational Interviewing (MI)
- Solution focused therapy
Group therapy may include:
- Group CBT
Family therapy may include:
- Group sessions with other families
- Group sessions that focus on parenting skills
Mindfulness-based therapies may include:
- Meditation
- Yoga
- Guided relaxation
Experiential therapies may include:
- Exercise
- Sports
- Outdoor activities
Expressive/complementary therapies may include:
- Visual art
- Creative writing/journaling
- Music
- Theater/drama
Community support may include:
- Peer support for patients
- Peer support for families
Medications (when indicated) may include:
- Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs)
Depression Treatment for Young Adults: About Cognitive Behavioral Therapy (CBT) and Mindfulness
Now we’ll take a moment to discuss two components of depression treatment for young adults offered at most well-respected treatment centers: cognitive behavioral therapy (CBT) and mindfulness.
Cognitive Behavioral Therapy (CBT)
Here’s a working definition of CBT provided by the National Alliance on Mental Illness (NAMI) describes CBT:
“By exploring patterns of thinking that lead to self-destructive actions and the beliefs that direct these thoughts, people with mental illness can modify their patterns of thinking to improve coping.”
In CBT, therapists help patients learn that patterns of thought are directly connected to and influence behavior. A CBT therapist teaches patients that individuals we all have fixed beliefs about ourselves, other people, and things that may happen to us at some point in the future. These patterns of thought appear most often during times of stress or high emotion. For a young adult with a major depressive disorder, these unconscious patterns of thought are often maladaptive and unhelpful.
A CBT therapist teaches a young adult patient about these cognitive distortions that may be a barrier to healing, which include patterns of thought such as black and white thinking, generalizing, catastrophizing, and exaggerating negative things/minimizing positive things.
A CBT therapist can help young adults replace maladaptive patterns of thought helpful and productive patterns of thought. Here’s a shorthand way to think of CBT: when habitual, unconscious patterns of thought cause negative emotions and actions, the way to change unwanted emotions and behavior is to first change the patterns of thought that precede them. CBT helps patients understand how they can manage their thoughts, emotions, in healthy, positive, and productive ways that promote healing and growth.
Next, we’ll discuss how mindfulness can help young adults with depression.
Mindfulness in Depression Treatment for Young Adults
Mindfulness is everywhere these days – because it helps a wide variety of people in a wide variety of ways. The core teaching of mindfulness revolves around a complete and full awareness of the present moment. Here’s how Thich Nhat Hahn, a Buddhist monk from Vietnam, widely credited with introducing mindfulness to the Western world, describes mindfulness:
“Mindfulness is our ability to be aware of what’s going on both inside us and around us. It is the continuous awareness of our bodies, emotions, and thoughts, without judgment.”
The judgment part of that definition is essential: during a severe depressive episode, a young adult may feel powerless. They may feel like they have no control of their overwhelming thoughts and no way to manage their emotions. Mindful awareness teaches them the perspective they need. When a young adult with depression uses mindfulness skills to slow down and pay attention, they learn they have power over their thoughts, and they can manage powerful emotions without feeling overwhelmed.
Mindfulness skills give patients with depressive disorders the tools to process thoughts and feelings in the manner of their choosing, rather than with unconscious patterns developed during childhood and adolescence. When they apply theses skills to the symptoms of depression – in combination with psychotherapy and medication, when needed – they can learn to manage the symptoms and live a full, fulfilling, and productive life.
How to Find Support: Online Resources for Families
- The American Academy of Child and Adolescent Psychiatry (AACAP) maintains a tool for locating professional support. Their treatment finder is convenient and easy to use.
- The National Institute of Mental Health (NIMH) maintains a page for youth, adolescent, and family mental health
- The National Alliance on Mental Illness maintains excellent resources for families
When seeking treatment for a young adult with depression, ensure any treatment program you consider follows a holistic, integrated treatment model, and offers programs that include cognitive-behavioral therapy (CBT) and mindfulness: those are two of the best and most effective treatments for depression available.
Remember: the sooner a young adult with depression gets the treatment they need, the better the outcome.
